Obstetric care at the intersection of science and culture: Swedish doctors' perspectives on obstetric care of women who have undergone female genital cutting

Abstract

Providing healthcare for women having undergone female genital cutting can present challenges. The women might require special obstetric care, including an anterior episiotomy (defibulation) for infibulated women. This paper explores how Swedish doctors caring for these women describe, explain and reason about their care and relevant policies in a Swedish context. A qualitative study was carried out with 13 chief/senior obstetricians and seven senior house officers. There was little consensus among the interviewed doctors on what constitutes good obstetric care for women with FGC or how care should be provided. Major problems include: inconsistent policy and praxis; uncoordinated care trajectories; diffuse professional role responsibilities; difficulties in monitoring labour and fetal status; and inhibited communication. The data highlight the need for increased awareness and reflective praxis both on the part of individual practitioners, and on an organisational level, which takes account of the special needs of different users.

Keywords:

• Communication
• cross-cultural care
• female genital cutting
• professional roles
• quality of care

Acknowledgements

We thank Professor emerita Gunilla Lindmark, Uppsala University for her engagement and constructive suggestions during the early stages of this study. We are also indebted to the interviewed doctors for their time and for sharing their thoughts with us.

Funding has been received from the Swedish Research Council. Funding has also been received for the first author's time through grants from the Karolinska Institutet.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.